Hi Dave.
Congratulations to Alan on his long-term survival. I hope you can keep that streak going.
Vidaza would probably be the treatment of choice regardless of his HIV status. Do you know what MDS subtype he was diagnosed with?
Why isn't Alan considered suitable for a transplant? Having HIV can put patients at a higher risk if they undergo chemotherapy and radiation as part of transplant preparation, but
this 2001 study of transplants for HIV-infected MDS patients was based on the theory that certain modifications to the standard transplant procedures would make transplants possible for these patients. However, no study results were posted. The modifications apparently proved to be successful, at least for lymphoma patients with HIV, according to
this more recent article. The doctor who wrote that article is also familiar with MDS, so you might contact her if you want a second opinion about the transplant eligibility for your husband.